Failures in endoscopic surgery of the maxillary sinus

Area of Science:

• Otolaryngology
• Surgical Outcomes Research

Background:

• Chronic rhinosinusitis without nasal polyps can significantly impact quality of life.
• Endoscopic sinus surgery (ESS) is a common treatment, but recurrence remains a concern.
• Identifying prognostic factors for recurrence is crucial for improving surgical outcomes.

Purpose of the Study:

• To investigate prognostic factors associated with recurrence after ESS for maxillary chronic rhinosinusitis without nasal polyps.
• To determine if intraoperative bleeding is an independent predictor of recurrence.

Main Methods:

• Prospective study of 411 patients undergoing ESS for maxillary chronic rhinosinusitis without nasal polyps.
• Analysis of ten potential prognostic factors including etiology, surgical details, comorbidities, and severity scores.
• Univariate and multivariate Cox proportional hazards modeling to identify independent predictors of recurrence.

Main Results:

• Recurrence occurred in 6.8% of cases.
• Univariate analysis identified preoperative endoscopic score, CT stage, and bleeding score as associated with recurrence.
• Multivariate analysis indicated that only bleeding score was an independent predictive factor for recurrence (P = 0.034).

Conclusions:

• Intraoperative bleeding may represent a risk factor for recurrence in ESS for maxillary chronic rhinosinusitis.
• Further research is warranted to validate bleeding as an independent predictor and to elucidate its role in surgical failure.